The peripheral nervous system can suffer damage, such as a brachial plexus injury.
What is the Peripheral Nervous System?
Peripheral nerves are also known as the peripheral nervous system, which contains “43 pairs of motor and sensory nerves” that make a connection between the central nervous system (brain and spinal cord) and the rest of the body. The peripheral nervous system is in charge of motor coordination, movement, and sensation. The following nerves are part of the peripheral nervous system: ulnar, tibial, sciatic, spinal accessory, radial, median, femoral, lateral femoral cutaneous, common peroneal, and brachial plexus.1
Peripheral Nerve Injuries
Because the peripheral nerves are complicated and fragile, they are easily injured. Some patients may have surgical interventions recommended to them. The types of trauma that can affect the peripheral nerves include tumors, entrapments and compressions (e.g., carpal tunnel syndrome), and injuries (e.g., brachial plexus injury).2 The brachial plexus nerves conduct the signals between the spinal cord and the hand, arm, shoulder, and chest. The nerves “originate in the fifth, sixth, seventh and eighth cervical (C5-C8), and first thoracic (T1) spinal nerves”. Inflammation, tumors, and trauma to the shoulder may trigger brachial plexus injuries. Sometimes they are caused by childbirth, and these brachial plexus injuries are known as “obstetric”. Others are considered “traumatic”, caused by falls or “direct violence or gunshot wounds, by violent traction on the arm, or by efforts at reducing a dislocation of the shoulder joint”.3 Brachial Plexus Injuries (BPIs) could also be caused by motorcycle accidents, blunt trauma, inflammation, compression, or neuropathies. BPIs fall into the following types: neuroma (tumor), neurotemesis (nerve is divided), axonotemesis (axons are severed), neurapraxia (nerve is compressed or stretched), rupture (nerve is torn), and avulsions (nerve is “pulled out from the spinal cord”). It depends on the injury if treatment is possible. Loss of sensation, muscle weakness, pain, and even paralysis are signs of a possible BPI.4
Some peripheral nerve injuries may heal on their own, and patients can seek rehabilitation. Others may require surgery.5 Contact sports might cause minor damage, such as “stingers”, where the BPI feels “like an electric shock or burning sensation” or leads to weakness or numbness in the arm. More serious injuries include symptoms such as severe pain, inability to use certain muscles, and lack of sensation. If the symptoms are recurrent or severe, it is important to seek treatment, as BPIs “can cause permanent weakness or disability”.6 Proper diagnosis is necessary in order to treat brachial plexus and other peripheral nerve injuries. Depending on the severity of the situation, if surgery is not warranted, chiropractic and massage can help some patients who seek an alternative to medications. Some patients have had their pain managed by electrical stimulation (TENS). After the initial trauma, patients can be advised by their chiropractor about exercises to increase range of motion. Hydrotherapy, massage, and chiropractic care can provide pain relief during rehabilitation. With proper treatment, some patients may move from a “flail arm” (little movement) situation to complete recovery. Healthcare providers can also give advice on how to avoid future injury.7
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